Effectiveness of Constraint Induced Movement Therapy and Bimanual Therapy in Children with Hemiplegic Cerebral Palsy

Introduction: The hemiplegic cerebral palsy (CP) is one of the disorders that involve paralysis on one side of the body. It is characterized by impairments of motor function of upper and lower extremities that involves unimanual and bimanual function of upper extremity. The constraint induced movement therapy (CIMT) and bimanual therapy promotes the unimanual and bimanual function and other function of upper extremity. The objectives of this study were-to find out and compare the effectiveness of CIMT and bimanual therapy in muscular tonicity, unimanual function, bimanual function, handle objects and in weight bearing in different position (prone lying, cross-leg sitting, 4-point kneeling) and protective extension in side and backward. Methodology: This study was an experimental type of design. Total 20 participants were included in where 10 participants in CIMT group and another 10 participants recruited in bimanual therapy (BT) group with age 2 to 12 years. The treatment dose was 1 hour, 3 days in a week. After 6 weeks follow up test has done. The outcome was measured by Modified Ashworth Scale (MAS), Pediatric Arm Function Test (PAFT) and Quality of Upper Extremity Skill Test (QUEST). The Wilcoxon signed rank and Mann Whitney U test were used to analyze the data. Results: The CIMT group improved statistically all the components of unimanual function (pless than 0.05) whereas BT group 50 % better in unimanual function. The bimanual function in CIMT improved 100 % (pless than 0.05), BT group improved 60 %. Weight bearing and protective extension were upgraded in CIMT group (pless than 0.05) but in BT group not found better outcome (pgreater than 0.05). Conclusion: This study investigated that CIMT and bimanual therapy are effective intervention in children with hemiplegic cerebral palsy. But CIMT group showed better improvement in all the functions of upper extremity for hemiplegic CP.